Benzodiazepines for Fear of Flying

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Prescribing Policy

Forest Hill Road Group Practice no longer routinely prescribes benzodiazepines (and related medications) for the treatment of fear of flying.

This page explains the reasons for this decision and outlines alternative options if you feel you need support to manage a fear of flying.

What are benzodiazepines?

Benzodiazepines are a group of medicines classified as controlled drugs. They are Class C / Schedule IV medications and include drugs such as:

• Diazepam (Valium®)
• Alprazolam (Xanax®)

They have sedative and anti-anxiety effects and are known to be addictive, particularly with long-term or inappropriate use. Some people feel they help reduce anxiety related to flying.

Why we do not prescribe benzodiazepines for fear of flying

Benzodiazepines are licensed for the treatment of anxiety disorders but are not licensed for the treatment of phobias. Fear of flying is generally considered a phobia, and prescribing these medicines for this purpose is therefore controversial.

In addition, since April 2019, under the terms of the Clinical Negligence Scheme for General Practice, NHS GPs are not legally covered to prescribe medications intended for use outside the UK, particularly where the prescriber does not have training in aviation medicine.
(This does not necessarily apply to private sector prescribing.)

There are also important risks associated with taking benzodiazepines when flying:

• Reduced responsiveness in an emergency: Sedation may impair your ability to understand and follow safety or evacuation instructions.
• Increased risk of blood clots (DVT): Benzodiazepines can cause an unnatural, non-REM sleep, leading to reduced movement during flights, particularly long-haul journeys.
• Increased aggression or disinhibition: A small number of people experience agitation or behavioural changes that could put themselves or others at risk.
• Legal risks abroad: Benzodiazepines are illegal in some countries. Carrying them may result in arrest, imprisonment, deportation, or disruption to travel plans.
• Reduced oxygen levels: Oxygen levels are lower at cruising altitude. Benzodiazepines can suppress breathing, potentially reducing oxygen levels further.
• Risk of dependence: These medicines are associated with addiction and dependence, particularly when used inappropriately.

What support is available for fear of flying?

We understand that this policy may be frustrating or distressing for some patients. While we do not routinely prescribe benzodiazepines for flying, the following options are available:

Fear of flying courses

Many patients find structured fear-of-flying courses helpful. These focus on education, coping strategies, and managing anxiety.

Examples include

• EasyJet Fearless Flyer
• British Airways – Flying with Confidence
• Flying Without Fear
• Fear of Flying

Further support

If you have ongoing concerns or would like to discuss this further, please contact Forest Hill Road Group Practice to arrange a discussion with a clinician.